Poor Spontaneous Recovery of Aphemia Accompanied by Damage to the Anterior Segment of the Left Arcuate Fasciculus: A Case Report

Abstract

Aphemia is a rare and special type of speech disorder, and the mechanisms underlying the occurrence and recovery remain unclear. Here, we present a clinical case of poor spontaneous recovery of aphemia, with the anterior segment of the left arcuate fasciculus server damaged and the posterior segment intact, as detected by diffusion tensor imaging. Aphemia could be caused by the disruption of the cortical and subcortical language circuits. In particular, our data support the view that damage to the anterior segment of the left arcuate fasciculus may result in poor spontaneous recovery from speech production deficits and that an intact posterior segment seems to be crucial for supporting residual language comprehension ability in patients with post-stroke aphasia. Collectively, these data imply the importance of the left arcuate fasciculus during recovery from the language disorder in the subacute stage of stroke.

Dissociation of white matter bundles in different recovery measures in post-stroke aphasia

“…L-AF AD effectively predicted subacute and chronic performance scores in our PSA cohort, consistent with previous findings linking AF to optimal language abilities in PSA individuals, including naming (39), repetition (40,41), comprehension (39) and spontaneous speech (42,43). Other studies that have tried to relate change scores and AF measures have not obtained significant results either (44)(45)(46).…”